Modern - Blog Science Connections

Highrisk
Standard
risk
Table 1. Clinical course in
Total study IV (1976-1977)
Number of patients 67 44
Early deaths 5 0
Complete remission 62 44
Number of relapses 34 14
Marrow 28 9
Marrow+ CNS 0 3
CNS 4 2
Testes 2 0
Remission deaths 2 2
Cumulative complete
remission 0,44±0.07 0.56±0.11
111
5
106
48
37
3
6
2
4
0.50±0.06
c. Discussion
The therapeutic value of intensive early therapy
for ALL remains controversial. Pinkel has
reported that this treatment phase does not
reduce the incidence of relapses (Pinkel 1979),
while Riehm et al. have concluded that intensi-
fied induction treatment definitively improves
the final outcome (Riehm et al. 1977). Because
of the recognized poor prognosis in patients
with high risk leukemia we decided to use more
intensive initial therapy in these patients.
However the 2 week consolidation therapy
with cytosine arabinoside and L-asparaginase
Cumulalive comp/ele remission
0.8
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Nt: Ralien/s
C.R. t: o.
1. < 25 K 10 1 11 2
2. 25-S0 x 10 3 8 3
3. 50-TOOx 103 16 2
t, . > 10011O} 8 2
C.R. = Comp/ele remission
E. /J. '"' Early dea/h
1 I
J
Fig. 6. Relationship of initial WBC to relapse-free survival in childhood acute lymphocytic leukemia, study
LSA 2 L 2
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